Thoughts on Preventing Fragile Systems Collapse

Re-Cap Before We Close the Loop

In part 1, I laid out a set of clear social fracture lines that can be expected to rupture and lead to system collapse. Spiritual is dealing with unresolved traumas. Cultural showing where people’s sense of purpose and values differ to a great degree. Lastly, the political realm starts to point to why the societal governance systems can’t self-correct.

This analysis led to Part 2, where I opined an application of a cybernetics systems model could begin to identify the parts of society which could be observed for signs of impending fragility.

The whole idea here is that all social action involves interaction between the environment, mechanics of change/adjustment, and the allocation of resources to facilitate change – fuel for the fire if you will.

That gives us the theory (Part 1), specification of structural factors (Part 2), and now we need to spell out the variables in a way that can be measured reliably. That would give us a ‘dashboard’ to monitor for signs of the avalanche. In conclusion, I will venture what went wrong with the health care system and how fragility could be corrected.

Mission Economy

Mariana Mazzucato in Mission Economy has lain out a stunning economic analysis of why our socio-economic post-industrial society can not seem to move from being reactive to one which is proactive and capable of mounting “moonshot” level programs. I highly recommend a detailed reading, and even you are not an economist. I’m offering a very condensed synopsis here.

One of her key insights and I quote: “In Chapter 4, we looked at fundamental attributes and principles that laid the foundation fo governments ability to lead a mission to the moon. Following on from those, five capabilities are, I believe, central to modern bureaucracies’ ability to manage complex and ‘wicked problems.”

1. Leadership and Engagement. Continuous engagement and a co-creating role with the market (polity).
2. Coordination. Coherent policy MIXES of instruments and funding. Working across silos.
3. Administration. Emphasis on diversity of approaches, ideas, and talents.
4. Risk-taking and Experimentation. Embrace uncertainty and learn through trial and error.
5. Dynamic Evaluation. Ongoing reflective evaluation based on complex objective data.

Stepping back a bit, ask yourself where in our current healthcare system(s) do these principles apply? And where would these system attributes be located in the viable systems model (VSM)?

Adaptive Organizational Analysis

When I read her conclusions about the capabilities required for a ‘moonshot,’ I thought, ‘yep, but let’s take it one step further. Remember Stafford Beer’s ultimate vision was a management control facility that did real-time monitor of the information flows among and between the levels of his viable systems model.

A short side note here. Beer was close to the implementation of an operational model for the country of Chile in 1972. A mock-up of the “Cybersyn” led off Part 2 of this series. Unfortunately, the assassination of Salvatore Allende ended the experiment, with Beer fleeing for his life. Another story for another time.

Years ago, I designed and built a quantitative organizational analysis system based on the characteristics – read attributes in Mazzucato’s terms – of the information flows between the ‘systems’ of the VSM. The model was built, tested, refined, and used in my organizational development practice since 1992. The final model has six factors.

Details of Factors and Underlying Assumptions

Direction: This scale reflects an organization’s mission, vision, and purpose and its ability to infuse that across the organization. The underlying assumption is that the more clearly this direction is defined and understood, the higher the company’s chance of success in orchestrating change.

Customer Service: This scale is a reflection of an organization’s connection to its customers. The underlying assumption is that the more closely a firm is connected to, understands the needs of, and is emotionally attached to its customers, the easier it is to spot emerging trends, correct process deficiencies, and change strategy to meet customers’ evolving needs.

Information Systems: This scale reflects an organization’s ability to use advanced information and communications technology. The underlying assumption is that the investment in, reliance upon, and use of continuously advancing telecommunication and computer technology facilitate a firm’s ability to change quickly and uniformly.

Personnel: This scale provides a direct reflection of an organization’s social capital. There is a direct correlation between a firm’s social capital and its ability to innovate and become sustainable over time. The underlying assumption is that the more social capital you have (and the greater your investment in creating even more), the more able you are to innovate continuously, change, and become sustainable over the long term.

Planning: This scale reflects an organization’s ability to anticipate change and respond to environmental or external pressures. The underlying assumption is that a higher degree of sensitivity to, and connection with, external events, trends, and forces enable a firm to change organizationally ahead of its competitors who aren’t so well attuned.

Facilities: This scale measures an organization’s ability to plan for, utilize, and continuously modify its use of a portfolio of physical facilities to support the work activities of its talent pool. The underlying assumption is that a wider variety and greater flexibility of design will be required to support the future workforce, compared to today’s standard practices.

The OAS is designed to provide decision-makers with a reliable, quantifiable assessment of a work group’s potential for successfully making a transition to a new way of functioning. In other words, how anti-fragile is the organization? How capable is it of dealing with ‘wicked’ problems? There is a national-level database with normed data with means and standard deviations for each factor. Further, validation research showed that, in 95% of the cases, workgroups that score more than one standard deviation below national norms on three or more of the five core factors fail to make a successful transition to a new work state.

Mapping the Viable System

I posit that the analysis developed by Mazzucato can be overlaid with the OAS. The OAS adds two new dimensions. Information Technology is a measure of the fidelity of the data flows between the systems of the VSM. Lastly, Facilities that I see as place branding have come to the fore with a concrete movement to a hybrid workPLACE model, including telemedicine.

Organizational Analysis System	Dynamic Capabilities (Mission Economy)
Direction	Leadership and Engagement
Personnel	Administration
Customer Service	Dynamic Evaluation
Planning	Coordination
Information Technology	Signal Processing
Facilities	Place Branding

Note that there is not an exact one-to-one mapping of factors between the two models. Risk-taking is actually the algedonic subsystem in the VSM top-level System – Five Policy. It measures how much risk will be tolerated or Beer’s words ‘unpleasantness or pain’.

Integrated Perspective

Now that we have an integrative systems measurement map, we can ask, what went wrong with the US healthcare system in the context of the COVID19 pandemic? Starting with Systems 1 (i.e., clinics, hospitals, teaching universities, and physicians’ offices), it appears that the information technologies linkages were attenuated. That is, the signals between them were dampened or didn’t exist at all. Direct care delivery systems were not coordinated. Further, the physical facilities themselves were inadequate. For example, the shortage of rural facilities. A Systems 2 failure.

Moving up a level to System 3 (Control), we have seen a breakdown in allocating resources to meet dynamic changes. For example, early on in the pandemic, the shortage and misallocation of Personal Protective Equipment (PPE). Later on, the same failure of internal audit processes pointed to supply chain problems with newly arrived vaccines.

The critical failure comes at the systems Four Level. The required management task here is to look outside the existing system and to the future. In the future’s world, we call this a lack of strategic foresight and the development of sets of alternative scenarios—failure to anticipate by leadership.

The function of System Five is to maintain overall homeostasis across all elements. Some would call this lack of unified purpose or sustainability. Fragility writ large. Subsystems running out of control and beyond their various design limits. Think of it as running out of Intensive Care beds, oxygen, and the most critically trained staff.

All elements of organizational health failed.

• Inadequate direction because of lack of strategic foresight
• Insufficient personnel to meet pandemic needs
• Breakdown in customer service or in Mazzucaco’s language, no dynamic evaluation.
• Deficient planning and coordination across service delivery units
• Truncated signal processing and
• Sub-optimal facilities

We should not be surprised at system collapse. Half a dozen states are under Crisis Standard of Care operational mode and running at about 2000 deaths per day.

Corrective Actions Mandated

First of all, put a systemic organizational analysis system in place that generates reliable quantitative data (e.g., Cybersyn) so that public health leadership can ‘feedforward’ corrective action signals based on an ongoing strategic foresight process.

This control system should have three primary functioning capabilities:

• Data/Intelligence between elements (Systems Ones)
• Early Warning indicators build into a ‘dashboard’ with trend analysis
• Unified policy decisions at System Five level

Resiliency = Sustainability

End the sounds of silence…